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General NPI Number Information
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NPI Number | 1710467253
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Entity Type | Individual
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Provider Name | BRETT FOWLER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 818 W GREENWOOD ST
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City | ABBEVILLE
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State | SC
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Zip | 29620-2515
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Country | US
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Telephone | 864-366-3253
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Fax |
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Provider Business Mailing Address
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Address Line | 420 THOMSON CIRCLE PHARMACY DEPT
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City | ABBEVILLE
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State | SC
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Zip | 29620
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 37695
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License Number State | SC
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